Online Referral System for Oral Surgery | Manteca

My Secure Practice Online To Better Manage Patient Care

Please use our new Collaborator portal to submit a new referral or manage new patient cases.

Please call our office if you have any questions: Manteca Oral Surgery Office Phone Number 209-823-9371.

This secure portal will allow you to refer patients to our office and collaborate on case development. Due to stringent HIPAA requirements, you must have an individual username and password to access this portion of our website. For first-time users, or if you have forgotten your password, please contact us to obtain your login info: Manteca Oral Surgery Office Phone Number 209-823-9371.

Oral Surgery Patient Referral Form

Please download and fill-out our Patient Referral Form. After you have completed the form, please fax a copy of this referral to the Tracy office at 209-834-0968 or the Manteca office at 209-823-8374. Thank you!

Download Our Patient Referral Form

Technical Note:

You need Adobe Acrobat Reader to view our form. Please download the free Acrobat Reader from Adobe’s web site if it is not already installed on your system.